Senior, 73, Freshman, 18% 162, 39% Junior, 69, 17% Sophomore, 110, 26% Freshman Sophomore Junior Senior Figure 7. Breakdown of Surveyed Population by Class Year. First-year Abusers 8% Upperclass Abusers, 48, 92% Freshmen Abusers Upperclass Abusers Figure 8. Percentage of Reported Abusers who are First-Year and Upperclass Students. This finding at WPI is consistent with DeSantis’ survey of students at the University of Kentucky, which indicated that reported abuse in the junior and senior student population is 16% higher than the reported abuse by first-year students. In this our study, there was a 16.5% increase in reported Adderall abuse from first-year to upperclass students. We speculate that an increase in reported Adderall abuse with the transition of first-year students into the second, third, and fourth years may be attributed to a harsher workload required of upperclass students, tempting them to resort to stimulants to cope with such work. Additionally, first-year students simply may not be exposed to such a drug upon entering the college atmosphere. It is likely they are 41
learning about Adderall from other students. This situation may be likened to alcohol use, in that alcohol abuse increases drastically from entering first-year students to upperclass students. Percentage of Surveyed Students who Reported Using and Abusing Adderall Questions 11, 12, and 13 (refer to Appendix, p. 87) allowed us to identify three groups of students. Students who answered yes to Questions 11 and 12 were classified as prescribed “Users”. Students who answered yes to only Question 13 were classified as “Abusers” because they reported off-label Adderall use. Students who answered no to all three questions were defined as “Bystanders,” as these students stated they do not take Adderall, nor are they prescribed the drug. There are approximately three times as many reported student abusers of Adderall as there are reported prescribed Adderall users. The chart below shows the percentage of student respondents who fell into the three groups. Users, 18, 4% Abusers, 52, 13% Bystanders, 344, 83% Users Abusers Bystanders Figure 9. Breakdown of Respondent Population into Three Groups. The pie chart shows the percentage of students who reported taking Adderall without a prescription (abusers), who reported being prescribed and taking Adderall (users), and who reported not taking Adderall nor having a prescription at all (bystanders). The overall abuse percentage (13%) is lower than in the studies discussed in the Literature Review. This may be attributed to several causes. Our study surveyed only just over 11% of the total undergraduate population, primarily students living in on-campus residence halls. The vast majority of students living off-campus were not surveyed, which may be a future poulation to survey. We conjecture that because off- campus apartments are not regulated by WPI-appointed residential advisors as residence halls are, they may be easier environments for Adderall trafficking. Another cause may be due to the relatively small size of the undergraduate population. A small student population could mean that more students know fellow students and are possibly afraid to use the drug with fear that they may be caught be several of their friends or classmates. 42
Obtaining the Drug Responses to Question 18 (refer to Appendix, p. 88) indicated that nearly half (44.4%) of the students who reported having a prescription for Adderall admitted to selling or giving away their Adderall pills. Furthermore, responses to Question 20 (refer to Appendix, p. 89) indicated that, of the 52 reported Adderall abusers, 41 (78.8%) of them reported obtaining Adderall from a WPI friend. This percentage implies a high level of Adderall trafficking on campus. Because there are approximately three times the number of reported abusers as there are reported users, it may suggest that either a single prescribed user is giving his or her pills away to multiple people, or that some prescribed users are simply not admitting to giving or selling their pills. This lack of admission may be attributed to fear of the legal ramifications of selling Adderall. Figure 4 displays the type of person from whom reported Adderall abusers said they obtained Adderall: Number of Reported Abusers WPI Friend Non-WPI Friend Stranger WPI Relative 41 Acquaintance 10 Series1 20 5 17 Type of People Who Sell or Give Adderall Figure 10. Number of Abusers who Reported Obtaining Adderall from Five Different Suppliers. Although the number of students who checked-off obtaining Adderall from a stranger was only five total, this number is still alarming. We speculate that these strangers are drug dealers from whom WPI students are buying Adderall. Non-WPI friends represent the second largest suppliers of the drug. It is possible that students buy the drugs from their friends from home before returning to school, or possibly from other schools near WPI. Students who reported obtaining the drug from a WPI acquaintance represent the third largest population. These acquaintances are likely friends of friends who use the drug, and are known to sell Adderall by word-of-mouth. 43
Reported Abuse in the Greek Life Population Four Greek houses, both fraternity and sororities, were surveyed. Students involved in Greek life at WPI represent 52.2 % (216) of the total respondent population. Of those in Greek life, 15.3% (33) admitted to using Adderall without a prescription. Students involved in Greek life represent both first-year and upperclass students. Figure 11 below graphically illustrates the surveyed population involved in Greek life and those who are not. The following graph, Figure 12, shows the breakdown of the abuser population. Non Greek, Greek , 216, 198, 48% 52% Greek Non Greek Figure 11. Greek vs. Non-Greek Survey Respondents. This chart shows the percentage of the surveyed population that listed Greek-life as an extracurricular activity. Non-Greek Greek Abuser, 19.0, Abuser, 33.0, 37% 63% Greek Abuser Non-Greek Abuser Figure 12. Reported Abusers Involved in Greek Life. This figure shows, of the total reported abuser population, who are involved in Greek Life. 44
Of the total survey population that is involved in Greek life, 15.2% reported abuse. Of the total survey population that is not involved in Greek life, 9.6% reported abuse. The relationship between those involved in Greek who are reported abuse is slightly significant (p, 0.05). The higher percent of Adderall abusers that are involved in Greek life may be credited to the environment in which these students live or interact. Greek houses are off–campus and not regulated by resident advisors as on-campus residence-halls are, possibly facilitating the use of this drug. Additionally, fraternity brothers and sorority sisters may also give or sell their prescriptions to fellow members of their organization, thus creating an easy, secretive, and high-trust environment for Adderall trafficking. The relationship between brothers and between sisters of fraternities and sororities, respectively, may also facilitate the giving or selling of Adderall. It is likely that students in Greek life who want Adderall may feel more comfortable obtaining Adderall from another brother or sister in their organization because they have already developed a trustful relationship with this person. Further, the lack of resident advisors or officials that live in these houses can create an environment that fosters Adderall trafficking and increases its accessibility. The result that students that are involved in Greek Life represent the largest reported abuser population is consistent with research done by Professor Alan DeSantis at the University of Kentucky, although he found that a much higher % of Greeks abused the drug there: His survey analysis of fraternity and sorority houses revealed that 80% of the students in Greek organizations have used a study drug to perform better in classes (CBSNews, p.1). Reported Abusers and Non-Abuser Involvement in Extracurricular Activities Question 6 (refer to Appendix, p.87) on the survey was used to determine the extracurricular activities in which students are involved. Students were able to check off as many activities as necessary. The majority of those categorized as reported abusers were relatively active in campus activities. 67.3% of reported Adderall abusers checked off being involved in two or more school-related activities, including athletics, honor societies, clubs, and Greek life. This percentage is more than double the number of reported abusers involved in only one school-related activity. Figure 13 describes the number of activities in which reported Adderall abusers are involved. None, 1, 2% 1 Acitivity, 16, 31% 2+ Acitivities, 35, 67% None 1 Acitivity 2+ Acitivities Figure 13. Level of Extracurricular Activity of Reported Abusers. 45
The jump in the percentage of reported abusers involved in two or more activities versus only one activity could possibly be a result of the added stress of dealing with schoolwork, in addition to the involvement in extracurricular activities. Students that are part of two or more activities plus schoolwork may feel they need an extra boost in motivation and energy. Further, involvement in certain activities, such as athletics and membership to honor societies is strongly dependent on scholarship. Therefore, it is possible that students who want to remain a part of such organizations may abuse Adderall to maintain a sufficient grade point average for participation. Extracurricular involvement of reported non-abusers was also investigated to determine if reported abusers are involved in more activities on-campus. Figure 14 displays the extracurricular activity level of reported non-abusers: 1 Activity None 38% 6% 2+ Activities 56% None 2+ Activities 1 Activity Figure 14. Level of Extracurricular Activity of Reported Non-Abusers. The percentage of reported abusers involved in two or more activities is higher than those students who reportedly do not abuse the drug and are involved in two or more activities. However, this difference is not significant (p-value, 0.0946). Reported non-abusers involved in only one activity was higher than the reported abusers involved in one activity. Again, this increase was not significant (p-value, 0.1197). Additional Substance Abuse Question 23 (refer to Appendix, p. 89) on the survey allowed us to determine which, if any, substances the reported Adderall abusers said they took in addition to Adderall itself. Respondents were allowed to check off as many substances that apply to them specifically, including alcohol, marijuana, tobacco products, cocaine, heroin, prescription painkillers, and prescription sedatives. 98% of the reported Adderall abusers also reported drinking alcohol. 67.3% also checked off smoking marijuana, and 55% 46
stated using tobacco products. These percentages sum to more than 100% because the same reported Adderall abusers who stated drinking alcohol also reported using other substances. 60% (28) reported abusers admitted taking three or more substances in addition to Adderall. While we cannot determine if reported abusers take these substances at the same time they take Adderall, the result that 60% of these reported abusers also supposedly use three or more of these substances, gives us the profile of what an Adderall abuser is like. We conjecture that a reported Adderall abuser, because he or she took Adderall willingly, will accept the risks associated with other substances known to be unhealthy or illegal. Number of Reported Abuses Alcohol Marijuana Tobacco Cocaine Heroin Precription Precription 51 35 Products Painkillers Sedatives Series1 29 7 4 7 6 Substances Used Figure 15. Number of Reported Abusers who Admitted to taking Various Substances. This bar graph shows the different types of substances listed on the survey, and the frequency with which reported Adderall abusers stated using them. For example, 51 reported abusers admitted to using Alcohol, and 35 reported abusers stated using marijuana. Reported Prescribed User Profile From Question 14 on the survey, we were able to determine for what reasons students, who were reportedly prescribed Adderall, used it. All but one (17 /18) student stated that he or she was prescribed Adderall to treat ADHD. The one student who was not, reported having narcolepsy. Question 15 asked the respondent if he or she took the Adderall prescription as directed by his or her physician. 50% of the reported prescribed users stated taking their prescriptions as directed by their doctors. 33% stated taking more than the prescribed amount, indicating some abuse. We did not categorize these as abusers, given our definition of that group being only those who take Adderall without medical authorization or prescription. Because this does constitute abuse, additional students might examine this issue further. The remaining 17% admitted taking the drug less often than as prescribed. The students admittedly taking their prescriptions less than prescribed could be one of the reasons for the buying and selling of 47
Adderall on the campus. Students have leftover pills in their prescription that they may not want to take, and thus have the ability to sell it. Coupling of Substances by Reported Users Question 16 (refer to Appendix, p. 88) was used exactly the same way as Question 23: to determine other substances that reported prescribed users take in addition to Adderall. It was found that reported prescribed users take fewer substances in addition to Adderall as compared to reported abusers. Alcohol use was more prevalent in the reported abuser population, however marijuana use was more prevalent in the prescribed user population. The following chart shows the different substances and the frequency of reported prescribed users taking them. Number of Prescribed Users Alcohol Marijuana Tobacco Cocaine Heroin Prescription Prescription Series1 16 13 Products Sedatives Painkillers 800 03 Substances Used Figure 16. Number of Reported Users who Admitted to Taking Other Substances. This bar graph shows the different types of substances listed on the survey, and the number of students who reported taking each substance. For example, 16 reported prescribed users stated drinking alcohol, and 13 reported prescribed users admitted to using marijuana. In contrast to Figure 15, which depicts the number of reported abusers that abuse each substance, reported users take fewer substances. Reported users did not check off using cocaine, heroin, or prescription sedatives, while reported abusers did. Additionally, the percentages of alcohol, marijuana, tobacco product, and prescription painkiller use were all smaller than those reported by abusers. We conjecture that those who do not report Adderall abuse are less likely to use these other substances. It is likely that doctors of patients who are prescribed Adderall educate and warn their patients about the risks of drug interactions with substances such as alcohol, marijuana, or tobacco. This data is represented visually using a bar graph rather than in a pie chart displaying percentages because some of the same respondents who reported using alcohol are the same ones who reported using marijuana or tobacco. 48
Giving and Selling of Adderall by Reported Prescribed Users Parts a) and b) on Question 17 (refer to Appendix, p. 88) allowed us to determine the different groups of people that ask reported users for their Adderall pills. These groups include WPI Friend, WPI acquaintance, non-WPI friend, stranger, or relative. 13 of the 18 (72.2%) reported prescribed users stated that people have asked them for pills from their prescriptions. The following chart summarizes the number of reported users who stated that various groups of people asked for their prescription Adderall. This data is not reported as a percentage because some reported users stated that people from different groups (i.e., a WPI friend and relative) both have asked them for pills. Number of People asking Prescribed Users WPI Acquaintance WPI Friend Non WPI Friend Stranger Relative 2 Series1 12 531 Type of People Who Sell or Give Adderall Figure 17. Number of reported users who stated that individuals from 5 Different Groups Asked for their Prescription Adderall. It is evident that several different types of people sometimes ask the same user for his or her prescription, indicating high demand of the drug. For example, one reported prescribed user stated that WPI friends, non-WPI friends, and relatives have asked him or her for pills. We speculate that, because most of the people asking the reported users for their prescription are WPI friends and acquaintances, there is a high amount of Adderall trafficking on campus. Only 8 (44.4%) of the reported prescribed users admitted to actually selling or giving pills from their prescriptions away. This number seems like a discrepancy in data because 41 (78.8%) of the reported Adderall abusers stated they obtain Adderall from WPI friends. This difference may be explained with two scenarios: these 8 reported users are giving away their prescriptions to multiple abusers, or some of these reported users are simply not admitting to giving or selling their prescriptions. 49
Students’ Reported Knowledge of Adderall Side Effects Question 7 (refer to Appendix, p. 87) was an open-ended survey question that prompted the respondents to list the side effects of Adderall to the best of their knowledge. Two researchers analyzed this question to determine the survey respondents’ level of understanding regarding the side effects of Adderall (positive or negative). Of the survey respondents, 62% did not respond to the question. This is potentially indicative of the lack of knowledge about Adderall in the undergraduate student body. Students leaving the question blank could suggest that they are not knowledgeable on any side effects. This percentage may also represent respondents who simply skipped the question out of lack of interest in the survey. Six categories of side effects were grouped as positive effects. These included: increased sociability (S1), increased concentration, focus, energy (S2), omnipotence (S3), calm (S4), euphoria (S5), and enhanced music appreciation (S6). These categories, delineated in tabular form, are listed in the Methodology. Approximately 30% of the students identified that Adderall increased concentration, focus, and energy. This was the most commonly identified positive side effect. Of the total respondents, just below 2% were able to identify the side effect of calmness. Every other positive side effect (S1, S3, S5, and S6) were only identified by a maximum of 0.05% of survey respondents. These results may demonstrate that most students are aware only of the increased focus side effect to which Adderall is attributed, a side effect which drives the employment of Adderall as a study aid in universities. Table 9 shows the total number of students who listed side effects within each category (S1 – S6) and the number of respondents who did not answer the question (NR). For example, Researcher 1 concluded that 257 respondents did not answer the question, and that two respondents listed sociability as an Adderall side effect. Table 10. Coding analysis of positive side effects with percent reliability. Positives NR S1 S2 S3 S4 S5 S6 Researcher 1 257 2 127 1 7 00 Researcher 2 258 1 123 1 6 00 #Answered/Total Collected Surveys (414) (Researcher 1) 0.621 0.005 0.307 0.002 0.017 0 0 #Answered/Total Collected Surveys (414) (Researcher 2) 0.623 0.002 0.297 0.002 0.014 0 0 Percent Reliability 99.7 99.7 99.0 100. 99.7 100. 100. Thirteen categories of side effects were grouped as negative effects. This list comprises the following side effects: forgetfulness (S7), increased anger (S8), repetitive behaviors (S9), fitful sleeping/sleeplessness (S10), lack of appetite (S11), nervousness/anxiety (S12), depression (S13), chills/sweats (S14), hallucinations/psychosis (S15), dry mouth (S16), increased urination (S17), physical body damage (S18), and addiction (S19). Nearly 10% of the survey students identified the side effect of fitful sleeping/sleeplessness (S10), while approximately 8% identified lack of appetite as an Adderall side effect (S11). These were the most 50
popularly listed negative side effects. All other effects within the negative branch of the coding tables were identified by only small percentages of the students that did answer the question. For example, of those who did answer the question, only 1.4% listed nervousness/anxiety (S12) as a side effect. This result is comparable to the coding analysis from the public forums in that sleeplessness and lack of appetite were two of the most common side effects reported. Table 11. Coding analysis of the negative side effects with percent reliability. Negatives S7 S8 S9 S10 S11 S12 S13 S14 S15 S16 S17 S18 S19 Researcher 1 2 6 1 40 30 12 3 0 1 0 0 11 6 Researcher 2 2 2 0 41 31 6 0 1 2 0 0 13 12 #Answered/Total 0.005 0.014 0.002 0.097 0.072 0.029 0.007 0 0.002 0. 0 0.027 0.014 Collected Surveys 0.005 0.005 0.099 0.075 0.014 0.002 0.005 0 0 0.031 0.029 (414) (Researcher 1) 0 0 #Answered/Total Collected Surveys (414) (Researcher 1) Percent Reliability 100 99.0 99.7 99.7 99.7 98.5 99.2 99.7 99.7 100. 100. 99.5 98.5 Of the general student population, most survey respondents did not respond to the question, while the second largest majority of students listed only two or three side effects. Tables 11 and 12 divide the respondent population by class year to determine if responses could be correlated to an increase or decrease in class year. The first row of Table 11, denoting “# of Side Effects Listed”, represents the numerical amount of side effects listed by respondents, either 0, 1, 2, 3, or more than 3 listed per answer to the question. The row of the table divides the respondents by class year. Table 12. Students reported knowledge of the number of negative side effects of Adderall. # of Side Effects 0 1 2 3 >3 Listed 49 13 8 30 Senior 52 14 2 10 Junior 90 16 2 20 144 13 4 01 Sophomore First-Year Table 13. Students reported knowledge of the number of positive side effects of Adderall. # of Side Effects 0 1 2 3 >3 Listed 7 66 0 00 Senior 7 61 1 00 Junior 9 97 4 00 11 147 4 00 Sophomore First-Year As summarized in tables above, of the 73 total senior class respondents, 90% (66 respondents) listed at least 1 positive side effect of Adderall and only 7 respondents left the question unanswered. Similarly 88% of the junior class, 88% of sophomore class and 90% of first-year class listed at least one 51
positive side effect. No respondents in any class listed more than 2 positive side effects. The result that the vast majority of students in all classes listed only one side effect of the several possible effects to which Adderall is attributed, could suggest minimal knowledge among the surveyed undergraduate population regarding Adderall side effects. Moreover, 67% of senior class, 75% of the junior class, 81% of the sophomore class and 88% of the first-year class did not list any negative side effects. Additionally, the number of negative side effects identified was generally lower than the number of positive side effects reported across the whole respondent population. From an average of results from researchers one and two, we found that positive side effects were reported more often than negative side effects. Approximately 85% of respondents reported positive side effects, while approximately 71% of respondents reported negative side effects. These percentages sum to more than 100% because some respondents listed both negative and positive side effects about which they were knowledgeable. The result that more positive side effects were reported may suggest that more students recognize the positive side effects of Adderall, instead of the negative effects. The results obtained here may be indicative of its use without legal prescriptions: students may not possess the required knowledge of both the positive and negative side effects of Adderall, which could possibly deter students from using it illegally. No definitive correlations were drawn that related class year with reported student knowledge of side effects. Perceived Ethics of Abusing Adderall Questions 8 and 9 (refer to Appendix, p. 87) allowed us to determine if respondents thought it acceptable to use Adderall to improve academic performance or for recreational use, respectively. The majority of the entire surveyed population (62%) stated they thought using Adderall to alter or improve academic performance was unacceptable. 17% reported that using Adderall for academic improvement was ethical, while the remaining 21% was unsure. The following figure shows this graphically: Not Sure, 88, 21% Yes, 69, 17% No, 258, 62% Yes No Not Sure Figure 18. Perceieved Acceptability of Abusing Adderall for Academic Improvement. This pie chart shows the percentages of students who stated using Adderall to improve academic performance was acceptable or not acceptable. 52
The percentage of those who stated it was acceptable to use Adderall to improve academic performance is 5% greater than the actual students who reported illegally using Adderall. This could mean that, although some students did not report taking Adderall illegally, they still may think it is ethically acceptable for others to use it illegally. The 21% of students that checked off “Not Sure” for the acceptability of academic Adderall use could possibly represent the student population that is not educated on what Adderall is or why students use it to improve academic performance. It may also represent students who are ambivalent or indifferent to the topic. Within the abuser population itself, 54% (26/48) answered “Yes,” meaning this percentage of reported abusers believes that using Adderall for academic improvement is acceptable. Of those who have legitimate prescriptions for Adderall, 39% (7/18) answered, “Yes.” Of the total bystander population, those who neither use nor abuse Adderall, 10% (36/348) answered “Yes.” A higher percentage of the total abuser population may believe using Adderall for academic purposes is acceptable because this is the group that is doing just that. The result that nearly 50% of the abuser population does not think using Adderall for academic improvement is acceptable, suggests that they may feel guilty for using the drug in such a situation. We also conjecture that only a very small percentage (10%) of the reported bystander population reportedly believes that Adderall use is acceptable for academic improvement because this population represents the group of students who have never used Adderall. The following chart displays the percentages of respondents who thought it was or was not acceptable to use Adderall for recreational purposes. Yes, 38, 9% Not Sure, 54, 13% No, 322, 78% Yes No Not Sure Figure 19. Response on Ethicality of Adderall use in Recreational Setting. This pie chart shows the percentages of students who stated using Adderall in a recreational setting was acceptable or not acceptable. The 9% of students who stated it was acceptable to use Adderall for recreational purposes could also be the same people that couple other substances while taking Adderall. As discussed in the Content Analysis section of this chapter, several individuals use Adderall in social or party settings to help them 53
become more sociable or talkative. The 13% of those who checked off “Not Sure” could, as in the chart before, represent the student population that are not aware of the employment of Adderall in the recreational setting, or simply have never heard of the drug before taking the survey. The “Not Sure” percentages from both charts suggest the need for the formation of programs to educate the student population on what Adderall is. Of the total abuser population, 27% (13/48) answered “Yes,” meaning this percentage of reported abusers believed that using Adderall for academic improvement is acceptable. Of the total user population, 28% (5/18) answered “Yes.” Of the total bystander population, 6% (20/348) answered “Yes.” Similar to above, we conjecture that only a very small percentage of reported bystanders (6%) believes that using Adderall for recreational purposes is acceptable, because these are the students that have never used Adderall. The 6% however, could suggest a group of students that may be inclined or tempted, due to their opinions, to try the drug in a recreational setting. Only a small population of the total reported abuser population believed that using Adderall recreationally was acceptable. This suggests that more of the reported abuser population is using the drug for academic purposes, such as studying and homework, rather than recreational reasons, such as partying. Summary of Key Survey Findings Prevalence of Abuse 13% of the total respondent population reported abusing Adderall. 4% of the total respondent populations reported having an Adderall prescription. There are approximately three times as many reported Adderall abusers as there are reported prescribed Adderall users. 33% of those students who are reportedly prescribed Adderall stated taking more than the prescribed dosage, indicating a type of abuse we did not originally intend to study. Abuser Profile 2.5% of first-year students reported abusing Adderall, while 19% of upperclass students reported abusing the drug Of those students involved Greek life, 15.3% admitted to using Adderall without a prescription, a percentage slightly higher than those who admitted Adderall abuse in the population as a whole. The percentage of reported abusers involved in two or more extracurricular activities was 11% higher than the percentage of reported non-abusers involved in two or more activities. Nearly all of the reported Adderall abusers reported drinking alcohol, two-thirds reported smoking marijuana, and over half reported using tobacco products. Alcohol use was more prevalent in the reported abuser population than in the reported non-abuser populations, yet marijuana use was more prevalent in the reported non-abuser population. Only reported abusers stated using more high-risk drugs including cocaine, heroin, and prescription sedatives. 54
Obtaining the Drug Nearly half of the students who reported having a prescription for Adderall admitted to selling or giving away their Adderall pills. Of the reported users, approximately 67% reportedly asked for Adderall pills from WPI friends, while 28% were reportedly asked for Adderall pills from WPI acquaintances. 79% of reported Adderall abusers stated they obtain Adderall from a WPI friend. 33% of reported Adderall abusers stated they obtain Adderall from a WPI acquaintance. Other sources of obtaining the drug include non-WPI friends, strangers, or relatives but these were less prominent. Opinions on Ethical Acceptability of Adderall Use A seemingly large anti-abuse attitude was reported by our respondent population, as 62% of the respondent population reported that using Adderall for academic improvement was unacceptable, while 21% was unsure. An even higher percentage of students, 78%, stated that using Adderall for recreational use was unacceptable, while 13% was unsure. Reported Knowledge of Adderall Side Effects 62% of the respondent population did not list any Adderall side effects when prompted by the survey. Positive side effects were more commonly reported as answers to this part of the survey. The most commonly reported side effects were increased concentration, focus, and energy, with 30% of respondents listing these effects as their answer. Approximately 85% of respondents reported the positive side effects of Adderall about which they were knowledgeable, while 71% of respondents reported negative side effects. Analysis of Personal Narratives Submitted via Online Website A total of nine personal narratives were submitted to our website constructed by SurveyMonkey. Similar to how survey respondents were categorized by population group, each website submission was placed in one of three categories: posts written by a reported abuser, by a reported prescribed user, and by a reported bystander. Content of the post was analyzed to answer several questions: For reported abusers, what were the side effects, methods of obtaining Adderall, and reasons for use as discussed in the posts? For reported users, is Adderall being taken as prescribed? Do reported users give or sell their pills to others? For reported bystanders, what are their thoughts on other students abusing the drug? Can narrative content support the conclusions made from the WPI survey data? Are these posts indicative of a wider range of students within the same abuser, user, and bystander categories? 55
Submissions from Reported Bystanders All reported bystanders were individuals who answered Question 4 on the website. Four responses were received. Three of the four posters stated explicitly that it was unacceptable for Adderall to be used by students without a prescription to improve academic performance. One of these posters likened the use of the drug by students to use of steroids by athletes. All four narratives are below: I think its completely unreasonable for some students to be able to take Adderall to aid in studying and thereby getting good grades. It sort of is like cheating because they are physically and mentally enhancing themselves to achieve something; much like athletes try to take steroids to improve their game. ADHD's diagnosis is really badly managed. They should be more strict on prescription. It is kind of sad that if i go in mimicking symptoms i will be able to get it. Thats probably the only way to police people....by limiting prescriptions and researching on a thorough diagnosis. Post 1 I think Adderall is abused a lot, and there should be awareness programs that target freshmen in college. If you can access freshmen, they will learn about the dangers of the drug and that it is very illegal. Post 2 I have never used Adderall without a prescription. I think that it is unethical and I think that the only thing that would help is an Adderall Awareness program targeted towards first year students. Most kids, I think, take the drug because they cant handle the stress and the work of college on their own and they need a little something to help them along. Also I heard that it helps some people but others have completely different side effects. Don't take adderall if you dont need it! Its not good for your body and it can send you to jail! Post 3 “I don't use Adderall and I don't think students should take it if they aren't prescribed it.” Post 4 Two stated that awareness programs targeted toward first-year students should be implemented to educate students on the dangers of Adderall. One poster suggested that prescriptions should be limited and that diagnosis methods for ADHD should be researched more thoroughly due to the ease of obtaining the drug currently. Opinions provided in these submissions are similar to those found from posts on the Student-Network forum. However, none of the posts on our website contained opinions from bystanders that condoned the off-label use of Adderall. This may be that only those students who submitted narratives to the site felt strongly enough against Adderall to publicize their opinions. 56
Submissions from Reported Users All reported users were individuals who answered Question 2 on the website. Two responses were received. I have ADHD and was diagnosed with the disorder when I was in the 6th grade. As I got older I got better at handling symptoms...focused a little better...got into trouble less....less frequent outbursts. I still took Adderall though, but when I got to college, I didn't need it as much. I still take it today, I'm in my second year of college. I take much less than prescribed. I should be taking it daily, but take it maybe once a week when I have a long night of homework or studying I need to do. I end up with a build up of pills. I sell those off to people I know personally at school. I have about 5 people I sell them to regularly, usually $2/pill. If I renew my prescription as scheduled but dont use all my pills, I end up having excess bottles filled with pills that I can sell/give away. Post 1 When i don't take my medication i get headaches and i find it very tough to do my homework. I think that adderoll makes me more awake, and increases my attention in class. I have been approached by floormates about my prescription, but i told them that i didn't have enough to sell and it affects my concentration too much. Post 2 The first narrative supports our conjecture that students who are prescribed the drug distribute it to one or several students on campus, leading to high levels of Adderall trafficking on campus. Both posts mention students who want to buy the pills from these prescribed users. This may suggest that these students are either not educated on the ramifications of buying Adderall illegally, or simply disregard these consequences. Monetary gain from selling the pills may also be a strong motivator these students. Submissions from Reported Abusers All reported abusers were individuals who answered Question 3 on the website. Three responses were received. I was about to fail a course last year, so on the second exam and final I took adderall prior to the exam night and crammed for 20+ hours of studying (right up until the exam). I found that Adderall allowed me to stay awake for a very long period of time, and the course material came a lot easier to me after taking adderall. I obtained adderall by buying some from my friend for 5$ a pill. A day after an exam I usually skipped class and missed breakfast because I felt very 'hungover' and tired. I passed my class because of adderall, and don't feel that it's illegal to take it to perform better in school. Post 1 This post shows the type of attitudes that some students may carry regarding the acceptability of taking Adderall for academic improvement. The effects of Adderall, as discussed in this post, paint it as a “wonder drug” for academic improvement, and underplay its harmful side effects. This attitude may be the reason why several other students take it for academic purposes. 57
The following post focuses more on the harmful side effects of abusing the drug: I first took Adderall when I was a freshman. My friend gave me a pill before a final...she got the pills from another mutual friend who had a prescription for Adderall because of her ADHD. I took the pill before the final, and felt amazing when it kicked in. When I was taking my exam, I did the whole thing in 15 minutes. And then re-did the whole exam again. I was amazed at how much faster you can read, write, and process information on Adderall. I kept taking Adderall off and on throughout the rest of the year. During B-term of sophomore year I began taking it more heavily, probably 3 times a week just to handle the work load of homework and tests. I stopped taking it at the end of B-term because I was experiencing horrible side effects. I couldn't sleep the same night I took the drug. My feet and hands felt cold and numb. My muscle were tense and sore. My jaw hurt from grinding my teeth. I chain smoked on Adderall...I don't know why, I just always had the urge to smoke. It was like smoking calmed me down from the high of Adderall. I didn't eat on Adderall, and then felt like my stomach was destroyed the next day. I got horrible dry mouth, chapped lips, bad skin. Horrible! I have since stopped taking the drug and have never touched it again. Fun when you're on it, and it works great for studying and getting stuff done, but the come- down and the day after are the worst! Post 2 These symptoms of sleeplessness, lack of appetite, and increased focus, are similar to those reported in the posts analyzed from the online forum Drugs-Forums.com. This reported abuser states the drug works well for studying, but also mentions several negative side effects that arose for abusing the drug, even others that were not included in the online forum posts, such as bad skin or numb feet. I obtain Adderall from multiple friends who are prescribed for mild ADHD. I only take it in times of tests -- rarely for recreational use. During times of tests i feel Adderall provides the concentration needed to absorb all the information from whatever it is i am studying. It also helps me stay up late (or all night, even) to complete all my studying. While i on the drug i have never come across any noticeable side effects. Its kind of like other drugs sometimes where your mouth gets dry and you are not really hungry for a while. But other than that its never anything serious. Recreationally though, i take Adderall to get even more excited to party! Plus it can keep me up almost all night and hang out with friends. My friends and I generally take other drugs for that purpose, but if they are not readily available i take Adderall. It only happened like a few times though. Post 3 This was the only post of the three reported abusers that included recreational use as a reason for using Adderall. The reason for using it recreationally, partying, was the same reason included in the Drugs-Forum.com posts. Posters on that site who used it recreationally were mostly for partying (instead of video games or cleaning, for example). 58
DISCUSSION Given the prevalence of widespread prescription drug abuse, and reports of Adderall abuse on other college campuses nationwide, we began this project with a concern about possible Adderall abuse on the WPI campus. Through administrator interviews, we learned that there is no available research on the issue and that some faculty members are not aware that this could become a possible problem among student populations. Therefore, it seemed relevant and important to survey as many undergraduates as possible about abuse of Adderall and present the results and recommendations to the entire campus community to help raise awareness. Prevalence The general results of the survey were positive: In comparison to other universities that have studied the prevalence of Adderall abuse on their campuses, WPI has a much lower level of abuse. Of the total surveyed population in our study, 13% of the respondents reportedly abuse Adderall. In our review of existing literature, we read that 34% of undergraduates at the University of Kentucky had reportedly taken attention deficit drugs without a prescription, and at the University of Wisconsin, a total of 16.8% students had reportedly used Adderall non-medically. It is possible that other universities that found a high population of reported student abusers conducted their studies because they were already aware of such a problem on campus. Abuser Profile We also sought information regarding the type of students who abuse the drug and developed a profile of students who reportedly abuse the drug. Our greatest population of abusers (92%) was in the sophomore, junior, and senior years of WPI. While we found that a significantly higher percentage of upper-class students reportedly abuse the drug as opposed to first-year students, there was no positive or negative correlation between the sophomore, junior, and senior year students and any reported Adderall abuse (i.e., we did not find that junior year students abused more than sophomores, for example). We speculate that an increase in reported Adderall abuse with the transition of first-year students into the second, third, and fourth years may be attributed to a harsher workload required of upperclass students, tempting them to resort to stimulants to cope with such work. Additionally, first-year students simply may not be exposed to such a drug upon entering the college atmosphere. It is likely they are learning about Adderall from older students who may have more experience with Adderall. To form further the abuser profile, we looked at the number of extracurricular activities in which students are involved to determine if the involvement related to any Adderall abuse. The percentage of students who reportedly abused Adderall and who are involved in two or more extracurricular activities, a reasonably hectic schedule, is 11% higher than the percent of students that reported no Adderall abuse and who are involved in two or more activities. Students that are part of two or more activities plus schoolwork may feel they need an extra boost in motivation and energy. Further, involvement in certain activities, such as athletics and membership to honor societies is strongly dependent on scholarship. Therefore, it is possible that students who want to remain a part of such organizations may abuse Adderall to maintain a sufficient grade point average for participation. How hectic students’ schedule is and their possible dependence on drugs to handle it may be a variable for a major future study. 59
The use of other drugs by reported Adderall abusers was also studied and compared to any substance abuse reported by the non-abuser population. In the reported Adderall abuser population, cocaine, heroin, and prescription painkillers were admittedly used, whereas in the reported non-abuser population, they were not. This may suggest that students in the reported abuser category are high risk- takers. It is likely that doctors of patients who are prescribed Adderall educate and warn their patients about the risks of drug interactions with substances such as alcohol, marijuana, or tobacco. Unprescribed users however are at a potentially great risk of continuous abuse and overdosing because they may be unaware of the dangers associated with the drug when mixed with other substances. Some students grouped into the reported user population (i.e., students prescribed Adderall), indicated some abuse also: about one-third of this population admitted to taking more than the prescribed dosage of Adderall, as directed by their doctors. This result could lead to another future study that focuses on Adderall abuse by those students who are legally prescribed Adderall to treat a valid ADHD diagnosis. Improvement in Adderall abuse should be focused not only on the strictly abuser population, but also on those patients who abuse the recommended dosages. In the reported abuser category of respondents, students involved in the Greek community were a large number. Of the total survey population that is involved in Greek life, about 15% reported abuse. Of the total survey population that is not involved in Greek life, approximately 10% reported abuse. This statistic that students involved in Greek Life represent the largest reported abuser population is consistent with research done by Professor Alan DeSantis at the University of Kentucky, although he found that a much higher percentage of Greeks abused the drug there: His survey analysis of fraternity and sorority houses revealed that 80% of the students in Greek organizations have used a study drug to perform better in classes (CBSNews, p.1). The higher percent of Adderall abusers that are involved in Greek life may be credited to the environment in which these students live or interact. Greek houses are off–campus and not governed by Resident Advisors as residence halls are, possibly facilitating the use of this drug. Members of Greek organizations may give or sell their prescriptions to fellow members, thus creating an easy, secretive, and high-trust environment that makes Adderall trafficking possible. The relationship between brothers and between sisters of fraternities and sororities, respectively, may also facilitate the giving or selling of Adderall. It is likely that students in Greek life who want Adderall may feel more comfortable obtaining Adderall from another brother or sister in their organization because they have already developed a trustful relationship with this person. Obtaining Adderall Further information regarding reported abusers’ methods of obtaining the drug was also researched. Nearly 80% of reported abusers stated they obtained Adderall from a WPI friend. This data suggests drug trafficking on the campus. The small undergraduate population might facilitate the buying and selling of Adderall. Moreover, the majority of our respondent population was students who live in on-campus residence halls. Each of these halls has WPI-appointed Residential Advisors who maintain the rules of the residence halls. We suspect the students living in off-campus apartments may live in an environment even more suitable to drug trafficking as there are no people maintaining rules and drug regulations in these areas as Residential Advisors do. However, it is possible that these students who live off-campus may not have access to large groups of students as those who live in residence halls do. 60
The number of reported users who admitted to giving away their prescriptions to WPI students is small, yet the percentage of reported abusers who stated that they obtain the pills from WPI students is high. This leads us to believe that either some reported users are not admitting that they sell or give away their pills for fear of legal ramifications, or that some of the reported users are distributing their prescriptions to multiple students. All of the narratives submitted to our constructed website from reported abusers of Adderall included details of these students obtaining Adderall from friends. The students obtained the drug by either buying the pill from friends, or getting it freely from their friends. From a previously conducted study by Checton and Greene, sellers were generally compatible with the compliance gaining strategies of rationale and promise. Furthermore, it was determined that the relative difficulty of obtaining Adderall prescription from peers or fellow students was very low. Therefore, it can be surmised that there are two major reasons for students diverting Adderall medication: ease of offloading and pressure from buyers of the drug through compliance gaining strategies. Such compliance gaining strategies may be applicable to WPI students as well. A future study could examine those Adderall users who sell or give away their pills to understand the motives behind this type of student drug trafficking. A future study of this nature could determine if students view selling Adderall as a profitable business endeavor or whether they feel pressured to sell these drugs to their schoolmates who ask for them. Another aspect of such a study would be to determine if these sellers are knowledgeable about the legal consequences associated from illegal trafficking. Reasons for Use Analysis of personal narratives to our website revealed details of why students reportedly use Adderall illegally. All of the reported abusers who submitted narratives to our website stated they took the drug for academic improvement. However, posts analyzed on public forums showed that the most common reason for Adderall use was for recreational purposes. This inconsistency with the forum created by our project could be that our website was open only to WPI students, and the public forum at Drugs- Forum.com we studied was open to people of all demographics, both students and non-students. 88% of the reported abuser population stated that they use Adderall for academic reasons (studying for exams, homework, projects, for example), while approximately 38% stated using it for social reasons (partying, for example). The academically competitive nature of WPI coupled with the intensity of the four-term school year may support the result that we saw the utilization of Adderall for academic purposes as the largest motive for use. The percentage of recreational users, however, is still a large figure. The large level of recreational use may be that students, because of such a hectic schedule, additionally use Adderall to “unwind” during the weekends or in a social setting. It is likely that these reported recreational users utilize Adderall as a de-stressing tool. Also, using the result that we saw sociability as the most frequently reported side effect on the public forums, Adderall could be used by WPI students as another tool to help students socialize with others. Knowledge about Adderall: Students’ Perception of Side Effects On our website prompting students to discuss their experiences with Adderall, respondents detailed several negative side effects of the drug including sleeplessness, dry mouth, and lack of appetite, among others. These symptoms were consistent with those found in the online forums researched in the early stages of this project. Despite these negative side effects, reported abusers noted the positive effects of the drug in terms of academic employment: all stated that it increased their focus, allowed them to study for long periods of time, and even saved them from failing a course. This data was also consistent with 61
findings from our survey with respondents more frequently recognizing positive side effects such as increased concentration and focus and negative side effects such as sleeplessness and lack of appetite. These types of positive attitudes toward Adderall abuse could be representative of the reasons why several other reported abusers take the drug. Additionally, this mindset of focusing more on the positive effects of the drug, in spite of the negative side effects that occur, could possibly be making students believe that Adderall is really a wonder drug. Several negative implications arise from this attitude. Students who reportedly use the drug without medical indication could become addicted to the drug, may be caught illegally with the pills, or may eventually suffer from the detrimental health effects that come from unprescribed use. Non-response to the survey question regarding students’ knowledge of Adderall side effects may be attributed to the unfamiliarity of the subject or simply laziness or indifference with answering the question. Respondents reported positive side effects more than negative side effects, suggesting that the general consensus among students is that Adderall can be abused without risk. This could potentially result in increased abuse of Adderall on campus because students may be more prone to make uninformed decisions about the drug. We did not find any correlation between class year and knowledge of side effects (i.e., fourth-year students did not report more Adderall side effects than, for example, sophomore year students). This suggests that Adderall education is required across all class years at WPI. One method of Adderall education would be to create an Adderall abuse program similar to existing alcohol abuse programs at the WPI SDCC. This organization is responsible for counseling students on alcohol and general drug abuse via educational programs already in place. The creation and installation of an Adderall- only abuse program would allow the SDCC to target the abuser population found in this study specifically. Students’ knowledge of Adderall side effects could be the major focus of a future study. We recommend the following for such a study: I) When testing for the students’ knowledge of the side effects of the drug, researchers use an equal number of respondents from each class to observe the specific trends in the analysis. II) Quantify the responses on a less general scale that incorporates more specific side effects as opposed to grouping the side effects to facilitate coding, as done in this project. For example, we grouped like-side effects into one coding category (i.e., fitful sleeping and sleeplessness was one category, but may be two separate categories). III) To increase the number of students who will actually answer the question regarding side effects, it may be useful to create a list of side effects: both positive and negative, that are specific to Adderall, but include health side effects completely unrelated to Adderall. Then, have students, on the survey, circle which ones they think are specific to Adderall. Because this is not posed as an open-ended question, it will likely increase the response rate. Perceived Acceptance The majority of the respondent population (62%) reported that using Adderall for academic improvement was unacceptable. While this large percentage shows a strong anti-abuse attitude, still 17% reported that they thought it was acceptable, while 21% was unsure. The percentage of those students who believe that it is acceptable to use Adderall for academic purposes is problematic as it stands. Moreover, the group of reportedly “unsure” students may be persuaded by health materials to refrain from using Adderall in the future. However, it is still possible that these students are, because of such an unsure attitude, that much more vulnerable to being persuaded in the other direction, toward abusing Adderall. 62
One possible method of lowering these two percentages may be through the construction of Community Advisor (CA) or Residential Advisor (RA) programs for the first-year students. As explained in the Methodology, CAs and RAs are required to hold programs throughout the semester that address various aspects of first-year student life, including time management, alcohol and drug abuse, and safe-sex education. We suggest that at least one program be dedicated to the discussion of Adderall, associated side effects, and the health and legal ramifications of off-label use. Informing first-year students early in their time at WPI may be an effective drug abuse prevention technique as this group is where we saw the least amount of abuse. As part of these programs, CAs and RAs may want to include real-life examples of Adderall abuse. These examples could be the same online narratives that we analyzed during our research, particularly ones in which these abusers had bad experiences on the drug. The insight and detailed experiences offered by these posts are informative and may even instill fear in students that may motivate them not to use the drug. Academic advisors should suggest that first-year students limit the number of extracurricular activities in their schedules during particularly difficult terms. For upperclass students, those completing multiple-term IQP or MQP projects, an agreeably stressful time, may want to lighten their extracurricular activities also. Advisors may suggest taking less demanding classes coupled with these projects. We saw the largest group of reported abusers was in the upperclass student population. While using the same abuse-prevention techniques we recommend for first-year students may not be as effective in this demographic, we suggest the school offer several time-management workshops, available to all upperclass students. Because we saw a higher abuse rate in students with busier schedules, showing students how to organize their day and manage their time may help prevent them from resorting to stimulant abuse to cope with such a demanding schedule. WPI should also distribute literature regarding Adderall. This may be in the form of posters around the school or brochures that discuss side effects, drug and alcohol interactions with Adderall, and legal ramifications of possession and distribution, all of which are topics especially important to a student abuser of Adderall. 63
CONCLUSIONS In conclusion, we recommend first that programs be generated by Resident and Community Advisors to educate first-year students on Adderall, with emphasis on the health and legal ramifications associated with off-label use. Educating students early in their WPI career may help prevent Adderall abuse, rather than later when it could become an actual problem. Results from this project may be useful by the Student Development and Counseling Center, an organization that handles drug and alcohol counseling for students. Currently at the SDCC there exist no programs dedicated solely to Adderall education. Research done in this program could aid those in the SDCC that are responsible for constructing programs that help educate students on drug abuse. Adding such a program will expand the breadth of how the SDCC helps students. Furthermore, the results of this project should be used by the SDCC for a WPI baseline record. Currently, there are no available statistics regarding Adderall abuse at WPI, and so this project will stand as the basis of comparison to future data that may be useful to this organization. Campaign literature to be used as an education tool regarding Adderall could be created via another Interactive Qualifying Project. Utilizing WPI students to create this literature is especially recommended, for various reasons. Students, rather than faculty, are likely more cognizant of the buying and selling that is occurring on the campus. Students who would potentially work on any extension of the project are already integrated into the student body that is using Adderall. This would give students a unique background for the project that faculty likely do not have. Surveys could be distributed annually and trends could be observed on a year-to-year basis. Analysis of the changing student body would indicate whether or not Adderall abuse levels on campus were increasing or decreasing on a much larger scale than our current data. More importantly, future researchers should aim for a larger respondent population to obtain a more accurate data set. With a larger data set, further correlations amongst majors, GPA, and student activities and likelihood of abuse could be generated. Results from this project represent just over 11% of the total undergraduate population at WPI. Also, this IQP may serve as a model for other schools that may want to survey their own undergraduate population to determine the frequency of Adderall abuse at their respective universities. Our paper survey and online website may serve as model research tools that could be implemented in other schools to gather similar data. Data collected in this project revealed that the abuse of Adderall within the undergraduate student body at WPI is a present issue. This project provides the administration with the necessary background to proceed with the steps to try to mitigate this abuse, while also standing as a model for other schools to quantify any possible Adderall abuse on their campuses. In an attempt to lower Adderall abuse on the collegiate level, showing students the negative effects of stimulant abuse, while simultaneously promoting better time-management skills, would help the same students compete in the demanding college atmosphere that exists today, but in a healthier environment. 64
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Kirsch, D. (M.D. of Boston University School of Medicine, 1979 in Psychiatry, Psychopharmacology, Psychotherapy) in discussion with the authors, December 2011. Levoamphetamine. (2007). Retrieved September 2, 2011 from: http://www.neurochem.comyr. com/epi_ra_files/levoamphetamine.png Magomedov, A. (n.d.). How to Convince Your Shrink You Have ADD/ADHD (2006). Retrieved December 14, 2011, from: http://exile.ru/print.php?ARTICLE_ID=8226&IBLOCK_ID=35 MedlinePlus. (2010). Dextroamphetamine and Amphetamine. Retrieved January 11, 2012, from: http://www.nlm.nih.gov/medlineplus/druginfo/meds/a601234.html Meyer, J. (2004). Effect of verbal aggressiveness on the perceived importance of secondary goals in messages. Retrieved September 1, 2011 from Communication Studies 2004: 55: 168-84. Microsoft Office Excel. (2012). “TTEST” Applies to: Microsoft Office Excel 2003. Retrieved January 11, 2012 from http://office.microsoft.com/en-us/excel-help/ttest-HP005209325.aspx National Center for Biotechnology Information. (2011). Attention Deficit Hyperactive Disorder (ADHD). Retrieved October 9, 2011 from http://www.nimh.nih.gov/health/publications/attention-deficit-hyperactivity- disorder/complete-index.shtml National Institute on Drug Abuse. (2002). Director’s Report to the National Advisory Council on Drug Abuse. Retrieved September 3, 2011 from http://www.apa.org/about/gr/science/spin/ 2011/09/drug-abuse.pdf National Institute of Mental Health. (2008). Retrieved November 11, 2011 from http://www.nimh.nih. gov/health/publications/attention-deficit-hyperactivity-disorder/complete-index.shtml Ness, E. (2012). Dangers of Adderall. Retrieved January 25, 2012 from http://www.ehow.com/abo ut_5418505_dangers-adderall.html RampWeb Web Accessibility Consulting. (2007). Retrieved January 25, 2012, from: http://www.RampWEB.com Salant, P. & Dillman, D. (1994). How to Conduct Your Own Survey. Hobroken, NJ, Wiley. Sheehan, K. (2001). E-mail Survey Response Rates: A Review. Journal of Computer Mediated Communication, 6 (2). Shire Pharmaceuticals. (2011). Retrieved from http://pi.shirecontent.com/PI/PDFs/AdderallXR_USA_ ENG.PDF Substance Abuse and Mental Health Services Administration, Office of Applied Studies. (2009). The NSDUH Report: Nonmedical Use of Adderall® among Full-Time College Students. Retrieved September 1, 2011 from http://oas.samhsa.gov/2k9/adderall/adderall.htm Sussman, S. et. al. (2006). Misuse of “study drugs:” prevalence, consequences, and implications for policy. Retrieved January 11, 2012 from http://www.substanceabusepolicy.com/content/1/1/15 Student Doctor Forums. (n.d.). Student Doctor Network Forums. Retrieved November 2, 2011 from http://forums.studentdoctor.net/index.php 67
Swanson, J. et al. (1998). Analog Classroom Assessment of Adderall® in Children with ADHD. Journal of the American Academy of Child & Adolescent Psychiatry, 37, 5, 519-526, ISSN 0890-8567, DOI: 10.1097/00004583-199805000-00014 The NSDUH Report. (2009). Nonmedical use of Adderall among full-time college students. Retrieved August 14, 2011 from http://oas.samhsa.gov/2k9/adderall/adderall.pdf Tolles, E. (Head of the Student Development and Counseling Center) in discussion with the authors, November 2011. Understanding Addiction. (2011). Dopamine – A Sample Neurotransmitter, Retrieved from http://www.utexas.edu/research/asrec/dopamine.html United States National Library of Medicine/PubMed Health. (2010). Dextroamphetamine and Amphetamine. Retrieved August 28th, 2011 from http://www.ncbi.nlm.nih.gov/pubmedhealth /PMH0000166/ Yan, S. (2006). Understanding Generation Y. Retrieved January 11, 2012 from http://www.oberlin.edu/ stupub/ocreview/2006/12/08/features/Understanding_Generation_Y.html Yun, G.W. & Trumbo, C.W. (2000). Comparative Response to a Survey Executed by Post, E-mail, and Web Form. Journal of Comuter Mediated Communications 6(2). 68
APPENDIX Table A-1. Excel data sheet of all collected IRB approved undergraduate surveys. This is the full coded data sheet organized in Microsoft Excel of the distributed surveys to the undergraduate population at WPI. Q1=GENDER; 1=MALE, 2=FEMALE Q2=AGE;1=17,2=18,3=19,4=20,5=21,6=22 Q3=CLASS YEAR;1=2012,2=2013,3=2014,4=2015 Q4=GPA;1=2-2.49,2=2.5-2.99,3=3-3.49,4=3.5-4 Q5=MAJOR;1=BME,2=ECE,3=CHE,4=BIOCHEM,5=MANAGE,6=RBE,7=CHEM,8=MA,9=ME, Q6=EX.ACTIVITIES;1=ATHLETICS,2=GREEK,3=CLUBS,4=HONORARY,5=NONE,6=OTHER Q7=OPENRESP;1=80%,2=60%,3=40%,4=20% Q8=ACADEMICS;1=YES,2=NO,3=NS Q9=SOCIAL;1=YES,2=NO,3=NS Q10=KNOW_ANYONE_THAT_TAKES_WITHOUT;1=YES,2=NO Q11=HAVE_ADHD;1=YES,2=NO Q12=HAVE_A_PRESCRIPTION;1=YES,2=NO Q13=YOU_TAKE_WITHOUT;1=YES,2=NO ID Q1 Q2 Q3 Q4 Q5 Q6 TOTAL ATHLETICS GREEK CLUBS HONORARY NONE OTHER Q7 Q8 Q9 Q10 Q11 Q12 Q13 S1 3 S2 S3 2 S4 S5 3 S6 S7 2 S8 S9 4 S10 S11 3 S12 S13 4 S14 S15 4 BIOCHEM S16 S17 4 S18 S19 4 ECE,CS S20 S21 4 S22 S23 4 S24 S25 3 S26 S27 3 S28 S29 3 BIOTECH S30 S31 2 S32 S33 4 S34 S35 4 S36 S37 3 S38 S39 4 S40 S41 2 S42 S43 4 S44 S45 2 S46 S47 2 S48 S49 2 S50 S51 3 S52 S53 3 S54 S55 4 S56 4 R1 R2 4 R3 4 R4 3 R5 R6 3 BIOCHEM R7 R8 4 R9 R10 3 R11 R12 2 R13 R14 4 R15 R16 3 R17 R18 3 R19 R20 2 R21 R22 3 R23 R24 3 R25 R26 4 R27 R28 3 R29 R30 3 R31 R32 2 R33 R34 4 R35 R36 4 4 4 4 3 IMGD 3 2 3 IMGD 134 3 AE 21 1 4 332 22 2 4 221 22 1 164 3 RBE 0 0 000 00 11 4 222 22 2 4 4 321 12 1 3 233 3 BB 2 151 2 ChE 2 11 3 69 4 2 3 1 4 ME/RBE 3 3 2 3 3 2 4 3 4 3 3 3 2 ActMA 4 3 1 2 3 2 4 3 ME/MGE 2 2 3 4
AZD 233 BIOCHEM 1 1 4 222 22 2 R38 251 BIOCHEM 1 1 4 321 22 1 Civil 1 R39 ME. 1 R40 ME/FPE 1 R41 Civil 1 R42 BME.. 1 R43 BME.. 1 R44 ME. 1 R45 BIOCHEM 1 R46 AE 1 R47 BIOCHEM 1 R48 EVE R49 ChE 1 R50 ChE R51 MAC 1 R52 ME/FPE R53 ME. R54 ME.. R55 ECE/RBE R56 BME.. R57 BB R58 ChE R59 MIS R60 ME.. R61 BB R62 Civil R63 ChE R64 Manage R65 ChE R66 BioChem R67 BME.. R68 BB R69 ME.. R70 BB R71 MG R72 ME.. R73 IE R74 BME.. R75 Act. R76 BIOCHEM R77 BME.. R78 BME.. R79 ChE R80 ChE R81 Civil R82 BME.. R83 BME.. R84 IMGD R85 EVE R86 Civil R87 BME... R88 BME.. R89 BME... R90 BME... R91 CH/EVE R92 CE/EVE R93 2 BME.. 2 1 R94 R95 3 ME.. 1 R96 ChE ME.. R97 Civil R98 ME.. R99 ChE R100 ChE R101 Act. R102 BME... R103 BME... R104 BME... R105 MGE R106 ChE R107 BIOCHEM R108 BME... R109 CH.. R110 ChE R111 ChE R112 BME... R113 BME... R114 UN R115 CH.. R116 BME... R117 BME... R118 Biotech R119 Civil R120 ME.. R121 ME.. R122 R123 R124 70
LCA 3 R125 3 R126 2 R127 3 R128 2 R129 3 R130 3 R131 4 R132 1 R133 2 R134 2 R135 3 R136 3 R137 4 R138 2 R139 3 R140 4 R141 3 R142 4 R143 2 R144 2 R145 4 R146 4 R147 4 R148 3 R149 3 R152 3 R153 2 R154 4 R155 3 R156 3 R157 4 R158 3 R159 3 R160 3 R161 3 R162 4 R163 3 R164 4 R165 3 R166 3 R167 4 R170 3 R171 4 R172 2 R173 4 R174 3 R175 4 R176 4 R177 3 PH/MA R178 2 R179 3 R180 1 R181 4 R182 3 R183 3 R184 4 R185 3 BIOCHEM R186 3 BIOCHEM S58 3 S59 3 S60 3 BIOCHEM S61 4 S62 1 BIOCHEM S63 3 S64 4 S65 2 S66 4 S67 4 S68 4 S69 2 S70 3 S71 3 S72 3 S73 1 S74 4 S75 4 S76 3 S77 3 S78 4 S79 4 S80 4 S81 3 S82 3 S83 3 S84 3 BIOCHEM S85 4 S86 3 S87 3 S88 2 S89 3 S90 4 S91 3 S92 4 S93 4 S94 4 BIOINFO S95 3 BIOTECH S96 4 MATH S97 2 ECE/RBE S98 3 S99 3 S100 4 S101 3 BIOTECH S102 2 S103 71
Morgan'4 3 CHE S104 4 CS S105 3 RBE S106 3 ME S107 3 BME S108 4 ME S109 3 ME S110 4 ME S111 4 ECE S112 4 CHE S113 4 ME S114 3 PH S115 3 BME S116 3 CE S117 4 RBE S118 4 ME S119 3 RBE/CS S120 3 AE S121 4 ME S122 3 ECE S123 3 CH S124 3 RBE S125 3 S126 2 UN S127 3 CHE S128 4 ME S129 4 ECE S130 4 RBE S131 3 ECE S132 3 AE S133 3 S134 4 ME S135 2 L2 2 L3 4 BIOCHEM L4 4 MANAGE L5 3 L6 4 ME,PH L7 3 L8 4 L9 4 L10 3 L11 4 L12 3 L13 3 L14 3 L15 3 L16 3 L17 4 ME,PH L18 3 L19 3 L20 4 L21 2 L22 3 L23 2 L24 3 L25 4 CHE,MA L26 3 L27 2 L28 4 L29 3 L30 4 L31 3 L32 3 L33 4 L34 3 L35 3 L36 2 L37 4 L38 2 BIOCHEM L39 3 L40 4 L41 4 IMGD L42 3 L43 4 L44 3 L45 3 L46 3 L47 4 L48 3 L49 4 L50 4 L51 72
RANDOM 3 1 N1 3 CHE 4 AE 1 N2 3 CE 1 N3 2 1 N4 3 N5 3 BME N6 2 MGE N7 3 BB N8 2 ECE N9 3 BME N10 2 BME N11 3 N12 4 S137 4 S138 4 BBT S139 3 CE:: S140 2 S141 4 S142 3 S143 3 PH S145 4 S146 3 S148 3 AE S151 2 S152 4 S153 2 S155 2 S156 3 CE:: S157 3 AE S154 3 BME S150 2 ACT S149 3 S147 3 CE:: S144 2 AE S158 S159 3 S160 2 PH S161 3 BB: S162 3 S163 S164 73
Table A-2. Excel data sheet of all collected IRB approved abuser und organized in Microsoft Excel of the distributed surveys to the undergradu Adderall. Q20=FROM_WHO;1=WPI_FRIEND,2=NOT_WPI_FRIEND,3=STRANGER,4=WPI_AQUAINT ANCE,5=RELATIVE Q21=WHATPURPOSE_1=ACADEMIC,2=SOCIAL,3=MANAGE,4=OTHER Q22=WHEN;1=DAILY,2=WEEKLY,3=MONTHLY,4=RARELY,5=OTHER Q23=OTHER_SUB;1=ALCH,2=MARJ,3=TOBACCO,4=COCAINE,5=HEROIN,6=PRE_SED,7= PRE_PAIN,8=NA ID Q20 WPI$FRIEND NOT$WPI$FRIEND STRANGER WPI$AQ RELATIVE Q21 ACADEMIC SOCIAL MANAGE PRE$PAIN NA R1 1 1 R5 1 1 R6 11 1 1 S123 1 11 N10 1 N9 1 1 N8 1 1 N6 1 N5 1 11 N4 1 1 N3 1 N2 1 1 N12 1 1 S144 1 1 S139 1 1 S138 1 S137 1 74 S152 1 S144 1 S147 1 S149 S154
dergraduate surveys. This is the full coded data sheet uate population at WPI that responded as abusers of OTHER Q22 Q23 ALCH MARJ TOBACCO COCAINE HEROIN PRE$SED 5 1 11 4 1 1 3 1 11 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
Table A-3. Excel data sheet of all collected IRB approved user underg organized in Microsoft Excel of the distributed surveys to the undergradu (The following table may be copied into excel for future reference). Q14=REASON;1=OBEASE,2=NARCO,3=ADHD Q15=INSTRUCTIONS;1=EXACT,2=LESS,3=MORE,5=OTHER Q16=OTHER_SUB;1=ALCH,2=MARJ,3=TOBACCO,4=COCAINE,5=HEROIN,6=PRE$SED,7= PRE_PAIN,8=NA Q17a=ASK_FOR_PILLS;1=YES,2=NO Q17b=IF_YES;1=WPI_FRIEND,2=NOT_WPI_FRIEND,3=STRANGER,4=WPI_AQUAINTANCE, 5=RELATIVE Q18=EVER_GIVEN_AWAY;1=YES,2=NO Q19=REASONS;1=ACADEMIC,2=SOCIAL,3=MANAGE,4=UNAWARE,5=OTHER ID Q14 Q15 Q16 ALCH MARJ TOBACCO COCAINE HEROIN PRE$SED PRE$PAIN NA Q17a Q17b UNAWARE OTHER 75
graduate surveys. This is the full coded data sheet uate population at WPI that responded as users of Adderall WPI$FRIEND NOT$WPI$F STRANGER WPI$AQU RELATIVE Q18 Q19 ACADEMIC SOCIAL MANAGE
Table A-4. Excel data sheet of the reliability testing from question #7 full coded data sheet organized in Microsoft Excel of the reliability testin undergraduate population at WPI. ID# NR POS S1 S2 S3 S4 S5 S6 NEG S7 S8 S9 S10 S1 1 S2 1 S3 1 S4 1 1 S5 1 S6 1 S7 1 S8 1 S9 1 S10 1 S11 1 S12 1 S13 1 S14 1 1 S15 1 S16 1 S17 1 S18 1 S19 1 1 S20 1 S21 1 S22 1 S23 1 S24 1 S25 1 S26 1 1 S27 1 S28 1 S29 1 S30 1 76
7 (open-ended) on the IRB approved survey. This is the ng from question #7 in the distributed surveys to the S11 S12 S13 S14 S15 S16 S17 S18 S19 11 1 111 1
S31 1 11 S32 1 S33 S34 1 77
S35 1 1 S36 1 S37 1 S38 1 S39 1 1 1 S40 1 1 S41 1 S42 11 S43 1 S44 1 S45 1 S46 1 S47 1 S48 1 S49 1 S50 1 S51 S52 1 S53 1 S54 1 S55 1 S56 EAST 1 R1 1 R2 1 R3 1 R4 TKE 1 R5 R6 1 R7 1 R8 R9 1 R10 1 R11 1 1 1 1 78
11 1 1 11 1 1 11
R12 1 1 R13 1 R14 1 1 1 R15 1 R16 1 R17 1 1 1 R18 1 R19 1 79 R20 R21 1 1 R22 1 1 R23 1 R24 1 1 R25 1 1 R26 1 1 R27 1 R28 1 1 R29 1 1 R30 R31 R32 1 R33 R34 1 R35 R36 1 R37 AZD R38 R39 1 R40 R41 R42 R43 1 R44 1 R45
11 11 1 1 1 11 1 1 1 1
R46 1 1 R47 1 R48 1 R49 1 1 1 R50 1 1 1 R51 1 1 R52 80 R53 1 1 R54 1 R55 1 1 R56 1 R57 1 1 R58 1 1 R59 1 1 R60 1 R61 11 R62 1 1 R63 R64 R65 1 R66 R67 R68 1 R69 R70 R71 1 R72 R73 R74 R75 1 R76 1 R77 1 R78 1 R79 1 R80 1
11 11 1 1 1
R81 1 1 1 R82 1 1 1 R83 R84 1 1 1 R85 1 1 1 R86 1 1 R87 1 11 1 R88 1 1 R89 1 1 81 R90 1 1 R91 R92 1 1 R93 1 R94 1 11 R95 1 R96 1 1 AP 1 1 R97 1 R98 1 R99 1 R100 1 R101 R102 R103 R104 R105 R106 R107 R108 R109 R110 R111 R112 R113 R114
1 1 1 1 1 11 11 1 11 1 1 1 1
R115 R116 1 R117 1 R118 1 R119 1 R120 1 R121 1 R122 1 1 R123 1 1 1 R124 1 1 LCA 1 R125 1 82 R126 1 R127 1 R128 11 R129 1 R130 1 R131 1 R132 1 R133 1 R134 1 R135 1 R136 1 R137 1 R138 1 R139 1 R140 1 R141 1 R142 1 R143 R144 1 R145 1 R146 1 R147 1 R148 1
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